Provider Demographics
NPI:1336750108
Name:HASSAD, FOUZIA
Entity Type:Individual
Prefix:
First Name:FOUZIA
Middle Name:
Last Name:HASSAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20800 US HIGHWAY 281 N
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7523
Mailing Address - Country:US
Mailing Address - Phone:210-497-5473
Mailing Address - Fax:210-497-1398
Practice Address - Street 1:20800 US HIGHWAY 281 N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7523
Practice Address - Country:US
Practice Address - Phone:210-497-5473
Practice Address - Fax:210-497-1398
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist